The association of primary ovarian insufficiency, early menopause and osteoporosis in the canadian longitudinal study on aging

Objectives The objective of this study is to describe the association of primary ovarian insufficiency (POI) and early menopause on bone mineral density (BMD) and osteoporosis in a cohort of women living in Canada. Methods Cross-sectional baseline data from the Canadian Longitudinal Study on Aging (CLSA) was used. Female participants of the CLSA were aged 45-85 at time of recruitment (Sept 2011 to Dec 2015, N=12339). Additional bio-psycho-social characteristics that may mediate bone health and the development of osteoporosis were explored. Results The average age of women at the time of baseline assessment was 65 years. There was no difference in hip BMD between groups. Compared to those who experienced menopause at a normal age, women with POI were more likely to have used osteoporosis drugs (11.39% vs. 7.63%) and have a higher rate of self-reported osteoporosis (21.91% vs. 16.65%). After adjustment for confounding, POI increased the odds of osteoporosis (OR 1.59). Other significant factors were insufficient calcium intake (OR 1.47) and current smoking (OR 1.63). Protective factors that decreased odds of osteoporosis included obesity (OR 0.41) and current HRT use (OR 0.65), but not duration of HRT use. Conclusions These results confirm findings from smaller cohorts illustrating that POI is a significant risk factor associated with osteoporosis. Increasing understanding of the sequelae associated with an earlier loss of ovarian function will aid in targeting earlier screening and intervention strategies for women in Canada and abroad.